What is Cleft palate?

Around week four to week seven of pregnancy, the baby’s lip begins to take shape. Faces are formed during pregnancy when tissue and specialised cells from both sides of the head grow toward the middle of the skull and fuse together. Features like the mouth and lips are created when different layers of skin and muscle come together. What we call a "cleft lip" occurs when the tissues of the lip fail to join before birth. Both the upper lip and the roof of the mouth (the palate) can be split open, a condition which is known as cleft lip and cleft palate. Cleft palates and cleft lips are prevalent birth defects. They typically manifest as single anomalies at birth but are linked to various genetic disorders and syndromes. The lip opening may be a narrow slit or a vast chasm that extends into the nasal cavity. A cleft lip can occur on either side of the mouth, in the middle of the lip or on both sides. Standard ultrasounds detect orofacial clefts like cleft lip and/or cleft palate in pregnant mothers. In particular, cleft palate is one condition that doctors can detect after a baby is born.

The symptoms that cleft palate causes include:

• Chronic ear infections
• Difficulty swallowing
• Difficulty with feeding
• Hearing difficulties
• Problems with teeth

Types of cleft lip and cleft palate

The following are the types of cleft palate and cleft lip that Dr Patel treats:

Types of cleft palate:

• Complete cleft palate- When the primary and secondary palates are affected, it is called a complete cleft. It starts at the uvula and continues up into the alveolar ridge. The primary and secondary taste buds are both used. A complete cleft palate can affect one or both sides of the mouth. A bilateral cleft palate can have two incomplete sides or two complete sides.
• Incomplete cleft palate- The uvula, located at the back of the palate, is the starting point for an incomplete cleft that continues forward. The incisive foramen may or may not be reached. Since it stops short of the front of the mouth at the alveolar ridge, we can say that it only affects the secondary palate. The severity of the cleft depends on how far forward it extends from the uvula. An incomplete cleft palate can take the form of a variety of conditions.

• • Bifid uvula- A cleft uvula, or bifid uvula, is one in which the uvula is physically split down the middle. The uvula can either have a small or large separation between its two sections.
  • Submucosal cleftoccurs when the palate, or roof of the mouth, fails to develop normally during pregnancy. A cleft is a mucous membrane separation that lines the mouth's roof and forms the palate.

• Soft and hard palate cleft- The entire soft palate and all or part of the hard palate up to the incisive foramen are included in a cleft involving both the hard and soft palates. In its most extreme form, the entire secondary palate (the area of the mouth between the uvula and the incisive foramen) is affected.
• Soft palate cleft- Cleft soft palates begin at the end of the uvula and terminate just before or at the juncture of the hard palate.

Types of cleft lip:

• Complete bilateral cleft lip- Bilateral lip openings involving the gum ridge and palate extend into the nasal cavity.
• A complete unilateral cleft lipis an upper lip cleft that starts at one side and extends to the nose.

• Forme fruste (microform) cleft lip- The mildest form of cleft lip is an incomplete cleft characterised by a single or slight separation. Compared to other types of clefts, microform cleft lips are less noticeable.

• Incomplete bilateral cleft lip- Splits in the upper lip into both sides but does not extend to the nose.
• An incomplete unilateral cleft lipis a split in the upper lip on one side that does not continue into the nose.

How can Dr Patel help?

Cleft lip and palate treatments help the patient eat, speak, and hear normally. Dr Patel tailors his surgical procedures for cleft lip and palate repair to the specific requirements of each patient. Following the initial cleft repair, your doctor may recommend follow-up surgeries to improve speech or the appearance of the lip and nose. Children with cleft lips should have surgery as soon as possible after birth and certainly no later than the first year of life. A cleft palate should be surgically repaired no later than 18 months.

FAQ